Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-06T11:04:15.180Z Has data issue: false hasContentIssue false
  • English
  • Français

The association between late-life cognitive test scores and retrospective informant interview data

Published online by Cambridge University Press:  19 July 2010

Riccardo E. Marioni ,
Fiona E. Matthews  and
Carol Brayne
Riccardo E. Marioni*
Affiliation:
Department of Public Health and Primary Care, University of Cambridge, CambridgeU.K.
Fiona E. Matthews
Affiliation:
MRC Biostatistics Unit, Cambridge, U.K.
Carol Brayne
Affiliation:
Department of Public Health and Primary Care, University of Cambridge, CambridgeU.K.
*
Correspondence should be addressed to: Riccardo E. Marioni, Department of Public Health and Primary Care, University Forvie Site, Cambridge CB2 0SR, U.K. Phone: +44 1223 763837; Fax: +44 1223 330330. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Cognitive assessment of older persons, particularly those with impairment, is hampered by measurement error and the ethical issues of testing people with dementia. A potential source of valuable information about end-of-life cognitive status can be gained from those who knew the respondent well – mostly relatives or friends. This study tested the association between last cognitive assessment before death and a retrospective informant assessment of cognition.

Methods: Data were analyzed from 248 participants from the Medical Research Council Cognitive Function and Ageing Study who were aged 71 to 102 years at death. Late-life cognition was assessed 0 to 8 years before death using the Mini-mental State Examination (MMSE) and the informant measure was taken 0 to 7 years after death using a Retrospective Informant Interview (RInI).

Results: Zero-inflated Poisson regression showed a strong association between MMSE scores and RInI scores – those scoring 29–30 on the MMSE had a RInI score four times lower than those who scored <18 (p < 0.001). The time between MMSE and death was also a significant predictor with each additional year increasing RInI scores by 12.4% (p < 0.001). The time between death and RInI was only a significant predictor when including measures that were taken four years or more after death.

Conclusions: Cognitive scores from retrospective informant interviews are strongly associated with late-life MMSE scores taken close to death. This suggests that the RInI can be used as a proxy measure of cognition in the period leading up to death.

Keywords

agingcognitive testingepidemiologydeath and dying
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 2 , March 2011 , pp. 274 - 279
Copyright
Copyright © International Psychogeriatric Association 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abreu, I. D., Nunes, P. V., Diniz, B. S. and Forlenza, O. V. (2008). Combining functional scales and cognitive tests in screening for mild cognitive impairment at a university-based memory clinic in Revista brasileira de psiquiatria, 30, 346–349. doi:S1516-44462008000400008[pii].CrossRefGoogle Scholar
Arnold, A. M., Newman, A. B., Dermond, N., Haan, M. and Fitzpatrick, A. (2009). Using telephone and informant assessments to estimate missing Modified Mini-mental State Exam scores and rates of cognitive decline: the Cardiovascular Health Study. Neuroepidemiology, 33, 55–65. doi:10.1159/000215830.CrossRefGoogle ScholarPubMed
Cole, M. G. et al. (2002). Systematic detection and multidisciplinary care of delirium in older medical inpatients: a randomized trial. Canadian Medical Association Journal, 167, 753–759.Google ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Hancock, P. and Larner, A. J. (2009). Diagnostic utility of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) and its combination with the Addenbrooke's Cognitive Examination-Revised (ACE-R) in a memory clinic-based population. International Psychogeriatrics, 21, 526–530. doi:10.1017/S1041610209008941.CrossRefGoogle Scholar
Henon, H., Durieu, I., Guerouaou, D., Lebert, F., Pasquier, F. and Leys, D. (2001). Poststroke dementia: incidence and relationship to prestroke cognitive decline. Neurology, 57, 1216–1222.CrossRefGoogle ScholarPubMed
Jorm, A. F. (2004). The Informant Questionnaire on cognitive decline in the elderly (IQCODE): a review. International Psychogeriatrics, 16, 275–293.CrossRefGoogle ScholarPubMed
Jorm, A. F. and Jacomb, P. A. (1989). The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE): socio-demographic correlates, reliability, validity and some norms. Psychological Medicine, 19, 1015–1022.CrossRefGoogle ScholarPubMed
Jorm, A. F., Christensen, H., Henderson, A. S., Jacomb, P. A., Korten, A. E. and MacKinnon, A. (1996). Informant ratings of cognitive decline of elderly people: relationship to longitudinal change on cognitive tests. Age and Ageing, 25, 126–129.CrossRefGoogle ScholarPubMed
Matthews, F. E., Stephan, B. C., Bond, J., McKeith, I. and Brayne, C. (2007). Operationalization of mild cognitive impairment: a graphical approach. PLoS Medicine, 4, 1615–1619. doi:10.1371/journal.pmed.0040304.CrossRefGoogle ScholarPubMed
MRC CFAS (1998). Cognitive function and dementia in six areas of England and Wales: the distribution of MMSE and prevalence of GMS organicity level in the MRC CFA Study. The Medical Research Council Cognitive Function and Ageing Study (MRC CFAS). Psychological Medicine, 28, 319–335.CrossRefGoogle Scholar
Pisani, M. A., Inouye, S. K., McNicoll, L. and Redlich, C. A. (2003). Screening for preexisting cognitive impairment in older intensive care unit patients: use of proxy assessment. Journal of the American Geriatrics Society, 51, 689–693.CrossRefGoogle ScholarPubMed
R Development Core Team (2009). R: A Language and Environment for Statistical Computing. Vienna: R Foundation for Statistical Computing.Google Scholar
Ready, R. E. and Ott, B. R. (2007). Integrating patient and informant reports on the Cornell-Brown Quality-of-Life Scale. American Journal of Alzheimer's Disease and Other Dementias, 22, 528–534. doi:10.1177/1533317507307032.CrossRefGoogle ScholarPubMed
Rockwood, K., Howard, K., Thomas, V. S., Mallery, L., Macknight, C., Sangalang, V. and Darvesh, S. (1998). Retrospective diagnosis of dementia using an informant interview based on the Brief Cognitive Rating Scale. International Psychogeriatrics, 10, 53–60.CrossRefGoogle ScholarPubMed